Tag Archives fordr alan shih

What is a Bunion?


A bunion is a deformity of the proximal or base joint of big toe. It is basically a bony prominence from realignment and enlargement of joint at the base of big toe. It is a progressive bony deformity and most commonly affects women. The deformity can lead to many problems and may cause the foot to rub on shoes, which can cause pain, redness and inflammation of first metatarsoophalangeal joint. This bunion is also knows as tailor's bunion or bunionette.

What causes Bunions?

In most of the cases , cause of bunion is still unknown. There can be some hereditary or genetic tendency to have abnormality at this part of this joint. In some cases it is also associated with joint problems such as osteoarthritis and rheumatoid arthritis. However, regardless of the underlying causes, wearing tight or unfit shoes tends to make the disease worse. Wearing such shoes puts some extra pressure on the base of big toe and causes friction of underlying skin.

Symptoms and Problems of Bunions:

  • Pain
  • Difficulty in walking
  • Infection at base of toe
  • Wideness of foot
  • Arthritis of big toe
  • Deformation of second toe​

Treatment of Bunions

If pain and symptoms of bunion persists, consult a podiatrist as soon as possible.

The primary aim of management and treatment of patient with bunions t is to relieve pressure on the bunion and stop the progression of the deformity.

A podiatrist may recommend these treatments:

Padding and Taping: This is the first step in the treatment of bunions.Padding the bunion decreases pain and allows the patient to continue a normal and routine life. Taping helps in keeping the foot in a normal position, thus reduces stress and pain.

Medication: Anti-inflammatory drugs and steroid injections are often prescribed to relieve acute pain and inflammation caused by joint enlargement and deformity.

Physical Therapy: Physical therapy can be very helpful in providing relief of the inflammation and bunion pain. Ultrasound therapy is a very popular and effective technique for treating bunions without surgery.

Orthotics: A foot pad or Shoe insert may be helpful in stabilizing foot and ankle and may reduce symptoms and prevent worsening of the disease

Surgical Options: When early treatments or medications fail or the bunion progresses past the threshold for such options, podiatric surgery may become necessary to relieve pressure, stress and repair the toe joint. Several surgical procedures and options are available to the podiatrist. The surgery will efficiently remove the bony enlargement, restore the normal anatomy and realignment of the toe joint, and relieve pain and inflammation.

Got Neuropathy?

Introduction & Acknowledgement

Welcome to the world of peripheral nerves and neuropathy. While the author has had significant training in his profession, current HENS president Dr. Richard Jacoby of the Scottsdale Neuropathy Institute and Dr. A. Lee Dellon exposed him to a novel approach to help preserve and improve nerve function in 2007. This remains a relatively new frontier and perhaps a well kept secret to many, even those in the medical profession.

There are two types of nerves: cents. nerves, primarily the brain and spinal cord, and peripheral nerves, nerves that extend to your arms and legs. When central nerves are damaged, they do NOT regenerate. When Christopher Reeves fell off his horse, he was left paralyzed with little chance of recovery because he injured central nerves within his neck. This publication will focus on peripheral nerves. The most exciting aspect of peripheral nerves is that following injury, they have the ability to regenerate) Carpal tunnel is an example of a peripheral nerve disorder, which can be improved with surgery.

Who is Dr. Dellon and Why Listen?

Dr. A. Lee Dellon, TAD, PhD is arguably the world's foremost authority in Peripheral Nerve Surgery. He has dedicated a life's work to understanding and treating nerve pa.. Follow.; graduation from John Hopkins School of Medicine in 1970, he completed 8 years of additional training including 2 years of research with the National Institutes of Health. Currently a Professor of Plastic Surgery a Neurosurgery at the John Hopkins University School of Medicine a the University of Arizona, Doctor Dellon has won fifteen national research awards, authored 72 book chapters, and published more than 375 articles in peer-reviewed journals.

He recently received a PhD for his basic science and clinical research into the surgical treatment of compressed nerves in the patient with diabetic neuropathy. He received his PhD from the University of Utrecht in the Netherlands on March 6, 2007.

Dr. Shih, Director of Neuropathy Services at Head to Toe Healthcare, is committed to improving & restoring sensation to neuropathic feet. He has completed the Lower Extremity Peripheral Nerve Surgery advanced train.g in Baltimore, accredited by the American Society of Plastic Surgeons and directed by Dr. A. Lee Dellon. There are roughly 220 surgeons, primarily consisiting of plastic, orthopedic, general, and podiatric surgeons worldwide who have received this training. Dr. Slob is a Fellow of the Association of Extremity Nerve Surgeons (AENS)

Why I Wrote This Book

Peripheral neuropathy afflicts millions of Americans. It is important to note that there are several types and causes. The most common form of peripheral neuropathy is diabetic peBpheral neuropathy. More than 60% of non-traumatic lower limb amputations are due to diabetic neuropathy. One in six diabetics will have ulcers of the lower extremity. One in six diabetics who have ulcerations will have amputations. Over 200,000 lower extremity amputations were performed in the United States and Europe last year. This is simply too much!

There is now hope for patients suffering from diabetic neuropathy, as well as other neuropathy causes. A relatively new surgical technique is allowing neuropathic patients to retain their limbs, live pain-free and have a better quality of life. For patients who had tittle chance for symptomatic improvement, we may now have the real opportunity to prevent ulcers and amputations in many diabetics.

Other causes of peripheral neuropathy are related to alcoholism, various chemotherapeutic agents, certain drugs, m well as a large group of idiopathic neuropathy (unknown muse). There are several scientific studies available that suggest an underlying theme with many of these varying types of peripheral neuropathy. Many of these peripheral neuropathies may be aggravated by a compression or squeezing of the nerve in tight tunnels the nerves must pass through.

What a Patient Has to Say about Peripheral Nerve Decompression?

Dr Shih,

Thank you for the follow up about my surgery. I am doing great after the surgery. I am no longer in pain and I have full strength back to my right foot. This is remarkable since it had been about 8 years that I started experiencing foot pain. After seeing 4 different foot doctors over the years and getting several orthotics. I still had pain. The shoe Inserts helped but did not fix the problem. After the surgery I can wear any shoe type and do any activity I want. I am 48 years old and I hike long and hard now. Thank You!

I am glad you had the technical expertise to find the real prob-lem with the foot pain and not just tell me to wear another shoe insert. As an Engineer I respect that level of competence in flooding the root cause of the problem and not just working on the symptom.

I would like to thank your office staff They were at as times very friendly and helpful.

Thanks again,